Coleman B D, Khan K M, Maffulli N, Cook J L, Wark J D
Department of Medicine (RMH), The University of Melbourne, Parkville, Australia.
Scand J Med Sci Sports. 2000 Feb;10(1):2-11. doi: 10.1034/j.1600-0838.2000.010001002.x.
Patellar tendinopathy is often treated surgically after failure of conservative treatment but clinical experience suggests that results are not uniformly excellent. The aim of this review was to (i) identify the different surgical techniques that have been reported and compare their success rates, and (ii) critically assess the methodology of studies that have reported surgical outcomes. Twenty-three papers and two abstracts were included in the review. Surgical procedures were categorized and outcomes summarized. Using ten criteria, an overall methodology score was derived for each paper. Criteria for which scores were generally low (indicating methodological deficiency) concerned the type of study, subject selection process and outcome measures. We found a negative correlation between papers' reported success rates and overall methodology scores (r= -0.57, P<0.01). There was a positive correlation between year of publication and overall methodology score (r=0.68, P<0.001). We conclude that study methodology may influence reported surgical outcome. We suggest practical guidelines for improving study design in this area of clinical research, as improved study design would provide clinicians with a more rigorous evidence-base for treating patients who have recalcitrant patellar tendinopathy.
髌腱病在保守治疗失败后常采用手术治疗，但临床经验表明，手术效果并不都非常理想。本综述的目的是：（i）确定已报道的不同手术技术并比较其成功率；（ii）严格评估报告手术结果的研究方法。本综述纳入了23篇论文和2篇摘要。对手术程序进行了分类并总结了结果。使用十个标准为每篇论文得出一个总体方法学评分。评分普遍较低（表明方法学存在缺陷）的标准涉及研究类型、受试者选择过程和结果测量。我们发现论文报告的成功率与总体方法学评分之间呈负相关（r = -0.57，P < 0.01）。发表年份与总体方法学评分之间呈正相关（r = 0.68，P < 0.001）。我们得出结论，研究方法可能会影响报告的手术结果。我们提出了改进该临床研究领域研究设计的实用指南，因为改进后的研究设计将为治疗顽固性髌腱病患者的临床医生提供更严谨的证据基础。
